title: Safety of the NiTi EndoCAR following chemoradiation in a porcine model.
abstract: OBJECTIVE
  To assess the safety of anastomosis ring (EndoCAR) following chemoradiation.
  
  
  METHODS
  A total of 10 pigs received radiation to a bioequivalent dose of 4500 cGy with 4 doses of 5-fluorouracil 400 mg/m(2) and leucovorin 20 mg/m(2) intravenous bolus. On day 21, each animal underwent 2 rectal anastomoses, 10 cm apart, using a 27-mm EndoCAR device and a 29-mm circular stapler. Burst pressures, desmosine and hydroxyproline levels and radiographic leaks were assessed at 2 weeks.
  
  
  RESULTS
  In all, 8 pigs were included in the analysis (1 pig died, 1 specimen damaged at harvest). Leaks occurred in 6 (170-300 mm Hg) stapled and 2 ring anastomoses (150-200 mm Hg; P = .13). Internal circumferences were similar (5.5 vs 5.2 cm; P = .5). Desmosine and hydroxyproline levels were similar between groups.
  
  
  CONCLUSIONS
  Rectal anastomosis, after chemoradiation to the pig rectum using a ring (EndoCAR), is similar to stapled anastomosis. Further trials are needed in humans to determine any clinical advantage associated with these findings.
authors.affiliation: Washington University, St Louis, MO, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Chun
authors.forename: Parag
authors.initials: P
authors.lastname: Parikh
authors.forename: Dooseok
authors.initials: D
authors.lastname: Lee
authors.forename: James
authors.initials: J
authors.lastname: Fleshman
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects* / Q000295:instrumentation*; D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology; D059248:Chemoradiotherapy; D005260:Female; D005472:Fluorouracil / Q000494:pharmacology; D002955:Leucovorin / Q000494:pharmacology; D023421:Models, Animal; D011879:Radiotherapy Dosage; D012007:Rectum / Q000187:drug effects / Q000528:radiation effects / Q000601:surgery*; D013528:Surgical Staplers; D013552:Swine; D014803:Vitamin B Complex / Q000494:pharmacology
chemical_list: D000970:Antineoplastic Agents; D014803:Vitamin B Complex; D002955:Leucovorin; D005472:Fluorouracil